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hcup-us.ahrq.gov/datainnovations/ICD10Imp_Romano_NAHDO_October2016.pdf
October 27, 2016 - Slide 1
ICD-10 IMPLEMENTATION:
OPPORTUNITIES AND CHALLENGES
FOR HEALTH DATA ORGANIZATIONS
1
Patrick S. Romano, MD MPH
Professor of Medicine and Pediatrics
UC Davis School of Medicine
Co-Editor in Chief, HSR
October 27, 2016
Outline
• Examples of opportunities and challenges in
ICD-10-CM/PCS specificatio…
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2022_Severity.PDF
January 01, 2022 - infections 8,517 0.05%
532: Menstrual and other female reproductive system disorders 10,135 0.06%
539: Cesarean … section with sterilization 89,045 0.54%
540: Cesarean section without sterilization 510,704 3.09%
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2021_Severity.PDF
January 01, 2021 - infections 8,998 0.05%
532: Menstrual and other female reproductive system disorders 10,050 0.06%
539: Cesarean … section with sterilization 91,024 0.54%
540: Cesarean section without sterilization 517,251 3.08%
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2020_Severity.PDF
January 01, 2020 - infections 8,977 0.05%
532: Menstrual and other female reproductive system disorders 9,552 0.06%
539: Cesarean … section with sterilization 96,197 0.58%
540: Cesarean section without sterilization 517,735 3.10%
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2019_Severity_V2.PDF
January 01, 2019 - infections 10,146 0.06%
532: Menstrual & other female reproductive system disorders 10,779 0.06%
539: Cesarean … section w Sterilization 100,070 0.55%
540: Cesarean section w/o sterilization 523,286 2.89%
541: Vaginal
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2021_Core_Weighted.PDF
January 01, 2021 - PROCEDURES 70,395 0.21%
779: ABORTION WITHOUT D&C 7,384 0.02%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 18,369 0.05%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 48,521 0.15%
785: CESAREAN … SECTION WITH STERILIZATION WITHOUT CC/MCC 103,911 0.31%
786: CESAREAN SECTION WITHOUT STERILIZATION … WITH MCC 121,450 0.36%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 264,657 0.79%
788: CESAREAN … SECTION WITHOUT STERILIZATION WITHOUT CC/MCC 575,082 1.72%
789: NEONATES, DIED OR TRANSFERRED TO ANOTHER
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hcup-us.ahrq.gov/reports/natstats/commdx/table2g.htm
February 11, 2011 - Cesarean section [134] 126,358 80.74 0.36 … Cesarean section [134] 100,708 67.49 0.29
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hcup-us.ahrq.gov/reports/natstats/commdx/table2c.htm
February 11, 2011 - Cesarean section [134] 38,966 10.28 0.11 … Cesarean section [134] 17,146 5.02 0.05
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hcup-us.ahrq.gov/reports/statbriefs/HCUP-SB-312-Appendices-508.pdf
September 01, 2024 - completed weeks of
gestation but before 39 completed weeks gestation, with delivery
by (planned) cesarean … section
MS-DRG v33-35 765–766 Cesarean section
MS-DRG v33-35 767–768 Vaginal delivery
MS-DRG v36 … +
774–775,
768,
796–798,
805–807
Vaginal delivery
MS-DRG v36+ 783–788 Cesarean section
ICD
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hcup-us.ahrq.gov/db/nation/nis/tools/stats/MaskedStats_NIS_2020_Core_Weighted_V2.PDF
January 01, 2020 - PROCEDURES 61,440 0.19%
779: ABORTION WITHOUT D&C 8,175 0.03%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 17,755 0.05%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 47,630 0.15%
785: CESAREAN … SECTION WITH STERILIZATION WITHOUT CC/MCC 111,195 0.34%
786: CESAREAN SECTION WITHOUT STERILIZATION … WITH MCC 110,830 0.34%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 246,805 0.76%
788: CESAREAN … SECTION WITHOUT STERILIZATION WITHOUT CC/MCC 574,555 1.78%
please refer to the section on Description
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hcup-us.ahrq.gov/db/nation/nis/tools/stats/MaskedStats_NIS_2022_Core_Weighted.PDF
January 01, 2022 - PROCEDURES 69,440 0.21%
779: ABORTION WITHOUT D&C 7,960 0.02%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 20,500 0.06%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 50,070 0.15%
785: CESAREAN … SECTION WITH STERILIZATION WITHOUT CC/MCC 98,385 0.30%
786: CESAREAN SECTION WITHOUT STERILIZATION WITH … MCC 131,905 0.40%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 279,940 0.85%
788: CESAREAN … SECTION WITHOUT STERILIZATION WITHOUT CC/MCC 549,410 1.67%
789: NEONATES, DIED OR TRANSFERRED TO ANOTHER
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hcup-us.ahrq.gov/db/nation/nis/tools/stats/MaskedStats_NIS_2021_Core_Weighted.PDF
January 01, 2021 - PROCEDURES 69,285 0.21%
779: ABORTION WITHOUT D&C 8,050 0.02%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 18,300 0.05%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 48,260 0.14%
785: CESAREAN … SECTION WITH STERILIZATION WITHOUT CC/MCC 102,915 0.31%
786: CESAREAN SECTION WITHOUT STERILIZATION … WITH MCC 121,355 0.36%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 269,050 0.81%
788: CESAREAN … SECTION WITHOUT STERILIZATION WITHOUT CC/MCC 567,259 1.70%
789: NEONATES, DIED OR TRANSFERRED TO ANOTHER
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hcup-us.ahrq.gov/reports/statbriefs/sb243-Severe-Maternal-Morbidity-Delivery-Trends-Disparities.pdf
February 01, 2018 - if the length of stay was—
• Greater than or equal to 4 days, if the delivery was vaginal or by cesarean … section
• Greater than or equal to 5 days, if the delivery was a secondary cesarean section
Additionally … section)
DRG = 371 (uncomplicated cesarean section)
DRG = 372 (complicated vaginal delivery)
DRG … section)
MS-DRG = 766 (uncomplicated cesarean section)
MS-DRG = 767 (uncomplicated vaginal delivery … section)
Exclusions ICD-9-CM = 630 (hydatidiform mole diagnosis)
ICD-9-CM = 631 (other abnormal product
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hcup-us.ahrq.gov/reports/factsandfigures/facts_figures_2006.jsp
January 01, 2006 - section (C-section)
800
1,304
1,346
4
5
6
9
4
4
68
Respiratory intubation … In addition to the newborn procedures, these included maternal procedures such as episiotomy, Cesarean … section, and fetal monitoring. … section
135
Forceps, vacuum, and breech delivery
136
Artificial rupture of membranes … section with complications and comorbidities
371
Cesarean section without complications and
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hcup-us.ahrq.gov/db/nation/nrd/stats/MaskedStats_NRD_2021_CORE.PDF
January 01, 2021 - PROCEDURES 37,670 0.22%
779: ABORTION WITHOUT D&C 3,828 0.02%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 9,826 0.06%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 25,922 0.15%
785: CESAREAN SECTION … WITH STERILIZATION WITHOUT CC/MCC 55,276 0.33%
786: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC … 66,598 0.40%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 143,720 0.86%
788: CESAREAN SECTION
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hcup-us.ahrq.gov/db/nation/nis/reports/NIS_1998_Design_Report.pdf
January 01, 1998 - As a simple example, each hospital’s number of cesarean sections would be correlated with their total … The number of cesarean sections must be obtained from discharge data, but the
number of deliveries is … Thus, if a regression can be fit predicting cesarean
sections from deliveries based on the NIS data, … that regression can then be used to obtain hospital-
specific estimates of the number of cesarean sections
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hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_2009_exhibit5_5.pdf
January 01, 2009 - of hip and femur 3 2 3 2
∞
Diagnostic spinal tap 2 2 2 2
Spinal fusion 1 3 1 3
∞
15-17 years
Cesarean … section - 27 - 44
Repair of obstetric laceration - 24 - 39
Appendectomy 12 9 19 14
∞
Episiotomy … years old, procedures related to pregnancy and childbirth were four of the most
commonly performed (Cesarean … section, repair of obstetric laceration, episiotomy, and forceps, vacuum,
and breech delivery)
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hcup-us.ahrq.gov/db/nation/nis/reports/NIS_1999_Design_Report.pdf
January 01, 1999 - As a simple example, each hospital’s number of cesarean sections would be correlated with their total … The number of cesarean sections must be obtained from discharge data, but the
number of deliveries is … Thus, if a regression can be fit predicting cesarean
sections from deliveries based on the NIS data, … that regression can then be used to obtain hospital-
specific estimates of the number of cesarean sections
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hcup-us.ahrq.gov/db/nation/nis/tools/stats/MaskedStats_NIS_2020_Core_V2.PDF
January 01, 2020 - PROCEDURES 12,288 0.19%
779: ABORTION WITHOUT D&C 1,635 0.03%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 3,551 0.05%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 9,526 0.15%
785: CESAREAN SECTION … WITH STERILIZATION WITHOUT CC/MCC 22,239 0.34%
786: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC … 22,166 0.34%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 49,361 0.76%
788: CESAREAN SECTION
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hcup-us.ahrq.gov/db/nation/nis/tools/stats/MaskedStats_NIS_2021_Core.PDF
January 01, 2021 - PROCEDURES 13,857 0.21%
779: ABORTION WITHOUT D&C 1,610 0.02%
783: CESAREAN SECTION WITH STERILIZATION … WITH MCC 3,660 0.05%
784: CESAREAN SECTION WITH STERILIZATION WITH CC 9,652 0.14%
785: CESAREAN SECTION … WITH STERILIZATION WITHOUT CC/MCC 20,583 0.31%
786: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC … 24,271 0.36%
787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC 53,810 0.81%
788: CESAREAN SECTION